UTI is always a possibility but she doesn’t seem symptomatic (well apart from the hallulus and fragmented retention) and her bloodwork was done yesterday for other reasons and her wbc is totally normal.
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If bloodwork was done, probaby not UTI.
A tidbit mentioned by hospital nurse was that in elderly UTI often comes without the usual symptoms of urinary urgency etc. (Hmm… wonder if that is maybe because some are in diapers, not paying attention.)
Just a thought. UTIs are typically diagnosed by urinalysis, not bloodwork. At least in folks of my age.
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Any infection also results in abnormal blood numbers though. Sorry for the stress!
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Not necessarily. Unless it spreads beyond the bladder and into the kidneys. BTDT.
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Ah, thanks for the correction. It can be challenging getting urine samples from elderly. We had to try for weeks to get one from mom.
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My mom had very concerning behavior when her sodium levels were low.
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This is correct of course, but she typically presents with a spike on her wbc. If she is still this disoriented next week they’ll run a urinalysis screen. (Nothing happens on the weekend in her AL)
I hadn’t known about sodium though.
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I have found it fairly easy to collect a specimen in a urine collection “hat” that goes under the toilet seat. These are much easier than trying to hold a specimen cup in the right place.
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Ugh, my dad needs to set up a bank account for the family trust, so there is someplace to deposit checks from Prudential that still come to my mom’s account (I do NOT understand how this work - will the quarterly checks keep coming forever?). My time in Austin next week is very limited, and it looks like I will be spending some of it in a bank branch, yay.
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Good luck with the bank chores. Do yo uknow what the Prudential checks are for?
Perhaps you can contact Prudential about this (if you have authorization) or perhaps your dad’s accounting person knows how this can be streamlined better.
Have a nice time in Austin outside of ‘tasks’.
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Delete
Sorry I apparently dont know what I’m doing today
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My 101 year old MIL is sharper than a tack. She played competitive bridge at a high level, played mahjong, led a book club, as well as read one book after another, followed the news, and even was at the No Kings protest last year.
Two months ago she slipped getting into the car and broke her ankle. Surgery was the next day, and she did great; interesting, they did not put her to sleep due to her age, so she just had Propofol. Took over a week to get her placed in a rehab that was accept her and she was willing to go to, as many were poorly rated, and the ones she was willing to go to, either didn’t have an available bed, or wouldn’t take her, most likely due to her age.
A few weeks into rehab she ended up in the hospital with stomach pain which after several days was shown to be due to a perforated ulcer. Over time, it was decided surgery would not be preformed, although my MIL was willing to take the risk of death. After much deliberation with her son and my SIL, it was decided she would go to a personal care home on hospice, although there was discussion with her going home with 24/7 care. She lived in an high end IL, in a very large unit, and could have afforded the 24/7 care. My personal opinion was her going home and being among her friends, most who were 20 years younger than her, would be best for her spirits, but she and her son decided on the personal care home. She is barely eating or drinking as it causes pain, although yesterday she ate some of her grilled cheese sandwich and a few chips, and only a few sips of her tea. I can not imagine she has that long without eating more than a couple of bite, but to see and talk to her, you would never know she was ill.
Of course the home isn’t all it professed to be, but maybe it will be ok. MIL is depressed with being totally dependent on others as she can not stand or walk due to her foot, and now loss of strength due to basically being bed ridden for 8 weeks. Living out her life in this tiny room vs. her large apartment, adds to her depression. The caregivers don’t come when you ring for them; she waited 10 minutes while I was there with her yesterday before someone came to check, and she used her buzzer 3 times. She wanted help to get into the wheelchair so she could eat her lunch that was brought to the room, even though she had told them she wanted to eat in the dining room.
MIL wants to have PT so she could at least stand and help get into a chair instead of having a 2 person transfer. She is willing to pay out of pocket, but her son, and the rest of us know she is too weak. I think hospice will give her a few days for comfort, but not what she wants. My understanding is any PT she receives is going to be for safety and comfort, not mobility.
So short story really really long, does anyone know if Medicare would pay for PT while on hospice? Should we have her just try to see what PT she gets with hospice to buy time? I have no skin in the game, as this was my husband’s step mother; she has been his mother since he was 13, as his mother died when he was 11. If he were still alive, he would have been deep in the medical decisions as he was a physician, and would have been having many discussions with her doctors.
What sucks about all of this is this woman is totally with it, and is just waiting for the day she dies. I would not be surprised if she decides on physician-assisted dying, although as of yesterday, she said she wasn’t ready to go to Oregon.
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Typically not unless a good case could be made for the PT being a comfort measure. IME that’s a hard bar to clear. She can opt to suspend hospice though to do the PT and then re-enroll in hospice if it’s important for her to try.
And FWIW, if she’s alert and oriented, the decisions should be hers to make, not her son and SIL’s.
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The decision to move to the personal care home and go on hospice was absolutely hers; she just had long conversations with her son and my SIL (my husband’s sister.) While I was not there, it seems they have many conversations and cries over her options. Yesterday when I was visiting, she told me the doctors all commended her for being able to make the decision she made, and agreed that it was the best decision. The only things was she didn’t get to see the facility before she moved, but did see their online page, pictures of the room she would go to, and the owner came to visit her in the hospital. My SIL and her husband were the ones to view the facility; MIL’s son did not see it, although everyone was good with that.
Going off hospice isn’t really an option from what I have been told. They have given up her apartment and will be moving her things out in the next week or so.
When you are 101, it is hard to build up your strength after a broken ankle and multiple hospitalizations. That said, if anyone over the age of 90 could do it, it would be her! But, without regular nutrients, she isn’t going to get stronger, and with the ulcer, she can’t eat or drink more than a few bits at a time.
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My MIL has now been on hospice for four years. She had to go off last summer when she broke her pelvis - you can’t get hospital care on hospice. She wasn’t strong enough to go to regular rehab, but the care coordinator at the hospital was able to get her into skilled nursing to begin rehab. The goal was to help her gain enough strength to allow her to eventually stand in order to transfer.
We found a new hospice that took over her care when she was done with her 21 days of rehab. We wanted her to get PT, and the hospice she had been with said it wasn’t possible. It actually is possible, but not all hospice companies will coordinate PT for their patients. This company not only coordinates PT, but they also coordinate OT.
MIL has been receiving PT in order to have the strength to stand. She isn’t “strong,” but she is able to stand to transfer - and on a good day, she can walk a bit with her rollator. The OT works to keep her swelling at bay, and it has really helped to reduce swelling in her legs. The hospice is committed to helping people live fully even while they are in their final days (or years, like MIL). They have not said anything about discontinuing PT or OT, and it’s been 7 months.
It would probably be best for your MIL to be in a different situation, but I understand … she gets to choose. Best wishes as you deal with all of this. It’s so hard.
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My father was in a hospice for 6 weeks. He did have a PT “evaluation” which his insurance covered. He was too unwell for PT, but the evaluation was to pacify him and give 3rd party the job of saying no PT “for now”
No AL is perfect and as we prepare to grieve it is natural to feel that all you see are the deficits in care. I also find the wait for an answer to the buzzer annoying!! I’m sorry your family is going thru this, it’s hard no matter what.
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My mom was in a residential hospice.
We had heard great things. At one point she was doing well enough that we thought we would have to look for another option but mom had a setback and passed away.
The day mom passed away, something was going on. I can only speculate but there was another resident who had many, many visitors who were quite disruptive. At one point we had a security guard tell us that all the medical staff was occupied. It wasn’t the peaceful experience that I thought. The night nurse was especially helpful and our other days there were different than the last.
My point. It depends on the day and the other things going on that day. I hope that tomorrow it will be better as far as finding help to assist.
It’s so hard no matter the circumstances.
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